Ask HN: Most accurate scientific book on human sleep?

[gautamsomani]

I am someone who is suffering from sleep problems since many years. And I want to know more on this topic. I read, at few places online including HN, that the book "Why We Sleep" is not completely accurate. Can someone recommend an ever more accurate book? Or "Why We Sleep" is the most accurate, albeit flawed, book out there?

I am also open to any series of articles/podcast or any scientific author to follow over a long time to learn about human sleep. I understand that not everything may apply to me, but still, learning is a good thing.

[Aurornis]

Books like “Why We Sleep” and podcasts like Huberman Lab are kind of like a junk food version of science: They deliver some bits of information that can be helpful, but they’re so coated in stretched truth, overconfidence, and stories crafted more to sound good than to be accurate that it’s not really accurate science material.

In a case like yours (difficulty sleeping) that might actually be fine, to be honest. A lot of people find relief from simply feeling like they understand a subject, rather than from having absolute accuracy of information. The confidence begets a feeling of control, which diminishes anxiety, which indirectly leads to better sleep.

These podcasts and materials often follow a pattern of suggesting some specific protocol based on loose interpretations of some underpowered study. The actual power of these supplements on routines is almost always much lower than the host says (Huberman is one of the worst at this) but the confidence with which the protocol is prescribed is often enough to convince people that it will work. The protocols and supplements turn into rituals and routines, which are cues for sleep, indirectly establishing a healthier sleep cycle with cues for relaxation.

On the other hand, some people get more anxious after consuming this material because they feel like not sleeping well is killing them, which creates more anxiety, which then worsens sleep.

I’ll let you decide which category you’re in.

For actual material on the subject: Sleep science and research isn’t as much about practical lifestyle tips as you might expect. The material that would be more helpful, practically speaking, is to pursue therapy-like modalities and relaxation techniques. You will find much more material about practically improving sleep from the therapy angle than you will from reading deep science on sleep architecture.

[darby_nine]

> are kind of like a junk food version of science

While I have long agreed with this sentiment, I'd like to gently push back against the idea that "science" is itself coherent, reliable, monolithic, or able to be digested by a single human at all. I suspect what you're actually comparing to is in-depth reading of published papers from which you draw your own conclusions—reliable or not—drawn arbitrarily from a pool where there's basically zero way to actually verify the quality of the papers you're reading. In this light I don't think it's a bad thing that people are given a glimpse of scientific understanding through pop-literature because the vast majority of people—even those that read papers—grossly overestimate the certainty of knowledge that they have not specifically specialized in.

This is a long-winded way of saying basically nobody interacts with "science" directly. It all comes down to trust, and I strongly suspect that the trust in a give pop-literature writer isn't that much worse-placed than the average person writing the academic papers in the first place—outside the topic of the paper, of course. It's incredibly difficult to aggregate knowledge without serious evidence about how trustworthy the publishers and writers are, and sadly credentials and brand prestige tend to be piss-poor evidence.

[Barrin92]

>In this light I don't think it's a bad thing that people are given a glimpse of scientific understanding through pop-literature

It is when you're doing "Huberman Math" https://x.com/bcrypt/status/1788406218937229780

This isn't a "glimpse into science", it's mostly the techbro version of Oprah trying to sell people vitamin supplements.

[loveparade]

What the... I was expecting some kind of math slip up, which can happen to all of us, especially in front of a camera. But this is just scary. No matter how tired or nervous you are, this isn't a mistake an educated person should make.

[darby_nine]

The curse of liberal society is that we will always struggle with defining who exactly is allowed to gatekeep knowledge. The liberal version of collective censorship comes from widespread consensus among publishers and distributers (and even that is rarely absolute, and I believe only a minority truly think this is possible).

For all we lament cancel culture and divisive discourse, our bookstore would look a lot worse without them, and I believe it's your patriotic duty to mock and decry people whom you perceive as harmful to society.

[haswell]

> I believe it's your patriotic duty to mock and decry people whom you perceive as harmful to society

I do think it’s our duty to engage in dialogue about the things that we feel are harmful to society. Dialogue is all we have to address issues peacefully, and how we use it is critical.

I disagree that mocking and decrying people is the answer. This may feel good for the person or group doing it, but does little to actually move the needle in terms of actual change. What it does do is drive a wedge between the people doing the mocking and those being mocked, and I’d argue this is at the heart of the increasing polarization we see across almost every subject.

The reality is that good people have questionable or downright bad ideas/beliefs and do things that are harmful. Attack bad ideas, yes. Argue for good ideas, even forcefully when necessary. Don’t attack people.

Almost nothing of value comes from mocking and deriding people when the end goal is to coexist in a free society, especially when achieving actual systemic change via legislation depends on people agreeing/coming together and is directly harmed by creating a zero sum mindset.

[darby_nine]

> This may feel good for the person or group doing it, but does little to actually move the needle in terms of actual change

I disagree completely. I find it's the idea of persuasion that has proved itself to be largely useless when people largely act irrationally and ground their worldviews in incoherent values and aesthetics. Meanwhile mocking people is an extremely effective form of communication.

[al_borland]

While the math might be a little off, telling people not to run to the OBGYN after not getting pregnant after one or two attempts isn't bad advice.

[cassianoleal]

Legit question, I've always wondered... Why do people in the USA spell and pronounce that word as if it were an initialism? I mean OBGYN or OB-GYN as I've seen spelled elsewhere as well. As far as I can tell, it's not 5 words but rather 2: Obstetrician and Gynecologist.

[al_borland]

We generally spell out titles for doctors or others in the medical field. PHD, MD, DDS, DO, OBGYN, etc.

It could also be, in part, because if it was lowercase people would try to say it instead of spelling out the letters.

People will often say “gyno” instead of gynecologist, if just talking about that.

[pedalpete]

Why We Sleep has some issues, but for a primer, it's a good intro.

I read that before I got into working in the neurotech/sleeptech space.

The Cambridge textbook The Neuroscience of Sleep and Dreams[1] I found surprisingly approachable. I've long had an interest in neuroscience, so it wasn't a completely new subject to me, but it wasn't a bad read.

I'm a life-long insomniac, you didn't go into the details of your sleep problems, and I initially read Why We Sleep because I was trying to understand sleep and fix my own problem. Unfortunately, I it's still all the same CBT-I stuff, sleep hygiene, etc etc.

We're not working in insomnia, I haven't found anything in the peer-reviewed literature which is convincing that anyone is near a solution in this space.

[1](https://www.cambridge.org/core/books/neuroscience-of-sleep-a...)

[vjulian]

My understanding is that scientific understanding of sleep is relatively limited and tenuous at that, compared to other medical topics. A professor at a sleep lab once joked to me that in fifty (or whenever) years, knowledgeable people will find today’s sleep science wrong. As such, I never seriously consider applying recommendations from “sleep science” to my personal life. (Though, to be fair, I’ve no problems sleeping.)

Is that an overly cynical perspective?

[pedalpete]

This is what I say all the time. Our understanding of sleep is at the same point our understanding of fitness and diet was in the 70s. I lived through that age, we understood it was important, but didn't know how it works, and are still discovering.

We've been building a consumer level sleep eeg headband, and are looking forward to learning more about brain function with huge volumes of sleep eeg data. Just looking at sleep stages isn't enough.

Of course, our goal isn't to get people to sleep with an eeg device, but we can't stimulate deep sleep without directly monitoring brain activity. We're https://affectablesleep.com

[mnode]

Yes, that is overly cyncial. The last 10 years or so has seen big leaps in our understanding of the fundamentals of sleep mechanisms. I think there's a long way to go, but we know enough that genuinely science-based advice can help a lot of people.

[alan-hn]

Understanding of sleep science is a rather different topic than applying known beneficial advice

[sva_]

Have you looked into how the light you get affects your sleep cycle? It's not a cure-all but definitely has a very strong effect on circadian rythm.

[pedalpete]

Yes, I put this in the bucket with sleep hygiene.

[dnissley]

Science is good, but it probably won't tell you how to fix your sleep. Especially not a book which is highly generalized. Experiment, experiment, experiment. Nerd the hell out. That probably means reading papers, but it also means trying out stuff like breathing exercises, meditation, yoga nidra, etc. It might even mean transforming your entire life and worldview. Attempting to find the most accurate scientific book on a subject is laudable in some respects, but also a severely limited approach if that's all you're doing. I wish you well on your journey.

[gandalfgreybeer]

Might be relevant but there was this old submission [1] debunking the facts behind "Why We Sleep"

1. https://news.ycombinator.com/item?id=21546850

[softwaredoug]

I really enjoyed "The Sleep Solution" by Chris Winter

It's less catastrophizing about bad sleep than Why We Sleep, has a good sense of humor, lots of great information about Insomnia and other problems. Unlike "Why We Sleep", Dr. Winter is a practicing sleep doctor so has perhaps more practical perspective.

https://www.amazon.com/Sleep-Solution-Why-Your-Broken/dp/039...

[vehicles2b]

A disclaimer is that I haven't read "Why We Sleep". Nonetheless I recommend the book "Sync" by Steven Strogatz (2003) -- particularly chapter 3 on sleep -- which describes a neat coupling of when we sleep / when we wake up to our body temperature which oscillates with a period of roughly 24 hours. (See figures on pgs 81 and 83.) Much of this discussion on sleep is derived from "isolation" research in the mid 1970's by Elliot Weitzman and Charles Czeisler, experiments in which subjects were isolated from all sense of time including daylight, clocks, and the news, to study their sleep cycles in the absence of external information telling them the time of day.

[lccerina]

Sleep researcher here. The most detailed you can find would be "principles and practices of sleep medicine", but that would not give you direct advice on how to solve your problems, more a general understanding of that.

If it's Insomnia, consider a cognitive behavioral therapist. If it's something else, look for the right expert. It can be also an external condition (e.g., do you live close to railways, airports, chemical plants?), diet and lifestyle, genetic factors etc... Without knowing what is your main sleep complaint is difficult to advice you.

[jrvarela56]

I used to have sleep issues and got rid of them with meditation. I got to a point where I could meditate 10-20 min straight and that was enough to quiet my mind into sleeping.

[ffhhj]

If I go to sleep before 11 pm, even if I'm sleepy, I'll have severe insomnia and won't be able to sleep until 3-5am the next day. But if I go to sleep at 12am, I'll automatically wake up at 6am perfectly rested. I say sleep science got it wrong at the minimum 8hr sleep to be healthy, just find your body's sleep schedule and follow it. As with water, only drink when thirsty and in rest, long before/after eating or exercising.

[YZF]

I think the science says it varies. If you wake up without an alarm and you're perfectly rested then good on you! If I sleep less than 8 hours I feel like I lost 10 IQ points and I'm tired most of the day.

[ffhhj]

That's what I say, know yourself, find your schedule. But I haven't found sleep science talking about it.

[Retric]

Science shows there’s underlying variability in sleep demands and these change based on age but people can also get used to less sleep even though they benefit from more.

In general newborns sleep 12-16 hours per day but not continuously. Age 6-12 average 9-12 hours. Teens average 8-10 hours. Between 25 and 64 most people are 7 to 9 hours which is where the 8 hours comes from. Seniors sleep less and rarely continuously through the night.

Talking about averages always excludes outliers. Some people are 6’6” and others 4’8, but odds are you’re still capable of sleeping more with better habits. There’s methods to learn how to fall asleep more easily and huge benefits from consistent sleep patterns. Further, it can make a huge difference what your room is like, lower temperatures and a lack of light is almost universally beneficial.

[jackrosacker]

I think it’s pretty commonly recognized that different people have different sleep duration requirements (within reason). The 8 hour rule is a popular rule of thumb, but in no way does current sleep science say that’s a hard rule that is true for everyone.

[dhruvkar]

Sleep is rest.

Rest and Activity go hand-in-hand.

I had sleep issues for 10+ years. I couldn't fall asleep most nights, would wake up tired, couldn't function without severe caffeine, which would lose efficacy over time and cause even more sleep issues and mind-bending headaches.

Sleep issues were just a symptom. It was my life (Activity) that needed fixing.

Look to your life -- if you fix things there, you'll fix your sleep.

If you want to talk further, feel free to reach out on email.

[kernx16]

I dug into this quite a bit for a while. A book that I found pretty good, albeit at times redundant, is "Say Goodnight To Insomnia". The author has studied sleep, specifically insomnia, for a good chunk of their life and uses CBT to conquer insomnia. The book also talks a bit about myths around sleep which I found interesting.

[ciwchris]

I also looked into this topic for several years due to my insomnia issues. Ultimately it took forming a new relationship with sleep for me. To let go. Easier said than done. An online CBT-I class helped me make this shift. I later read the book Hello Sleep [1]. It shared information similar to what I learned on my journey. I recommend the book.

1: https://drjadewu.com/

[kva]

A somewhat niche but good book on sleep-disordered breathing is "Life Saving Sleep" by Barry Krakow [1].

If you have a ton of sleep problems, you should probably catalog them, and try seeing a somnologist or getting an in-lab sleep study.

[1](https://www.amazon.com/Life-Saving-Sleep-Horizons-Treatment/...)

[LolBatmanHuntsU]

It's a bit cliche but the most accurate book is the one you can write for yourself.

Seriously, make yourself a guinea pig, experiment and have fun. All whilst making note of how things are affecting your sleep.

Here are some starter experiments:

-no tech within 1 hour of bedtime

-do household chores or go for a walk/run a few hours before sleeping

My last tip for all of this is to have self-compassion, a majority of things won't work but that's the methodologies problem not yours. Decide if you want to tweak it or move on.

Good luck and best wishes.

[ides_dev]

I enjoyed reading Life Time by Russell Foster [1]. Professor Foster is the Head of Oxford’s Nuffield Laboratory of Ophthalmology and the founder and Director of the Sleep and Circadian Research Institute. In it he covers lots of aspects of sleep and ways to try and improve it.

[1] https://www.goodreads.com/book/show/58417761-life-time

[TastesLikeChckn]

Learn to meditate. One hack I use is to listen to a Delta rhythm trance which is the deepest brain speed. It is so powerful that the task is to stay awake. I made my recordings using Gnaural, which may still be available. When in this state you can reprogram your unconscious. Wear earbuds or headphones lay in bed, without committed diligence, you will be sleeping.

[arihantparsoya]

Have you been exercising?

[srik]

Sounds basic but wearing yourself out with workout is extremely effective; gets your body itself to "want" to go to sleep, no mental tricks needed.

[sabrina_ramonov]

reading Breath: The New Science of a Lost Art helped me more than Why We Sleep and other sleep books. I have sleep apnea and have tried many solutions, including mandibular devices. Putting on mouth tape to force myself to breath through my nose did the trick. No sleep doctor or sleep dentist ever mentioned this inexpensive solution to try.

[JSDevOps]

Id be interested in this also

[wateroutflow]

What kind of sleep problems?

[nonameiguess]

The long and short of it is that it's basically impossible to do interventional studies on sleep deprivation in which you can see longitudinal as opposed to acute outcomes. Interventional studies are all short duration because no research subject is going to be willing or probably even able to comply with long-term sleep deprivation, and interventional studies on the order of decades over which things like cancer and death tend to happen are rare anyway simply because you can't intervene in a research subject's life for that long a span of time.

So understand the limitations of observational epidemiology studies. Correlations are observed between some outcome of interest (i.e. cancer and death) and a variable or variables these may or may not be impacted by (i.e. duration, quality, and regularity of sleep). If you observe a positive correlation, well, what causes it? Maybe poor sleep gives you cancer. Maybe cancer gives you poor sleep. Maybe a life full of terrible stress gives you both poor sleep and cancer. The researchers can't possibly know. This type of research is done to find interesting correlations that can then be investigated further by conducting interventional studies.

This is what the public doesn't seem to understand. Observational studies in nutrition and exercise science and what not are always being posted to Hacker News, but these are not really meant for public consumption. They're meant to suggest avenues of further research by other scientists. You see the same thing with various classifications by standards bodies, for instance, the IARC carcinogen thing. They classify compounds as possibly carcinogenic not to warn people off of using them, but to suggest to other researchers what they should bother and not bother looking into.

Unfortunately, as I stated in the first paragraph, it is hard to go further with sleep science. The problem with the book "Why We Sleep," caveating here that I haven't read it personally, is I'm pretty sure it goes beyond what the evidence warrants in order to state with far too much certainty that losing sleep causes a whole lot of bad outcomes when we do not know that to be true. My engagement with this largely goes back to the earlier Hacker News threads about this book and the Barbell Medicine and Stronger by Science podcasts going into fairly detailed debunkings of it and breakdowns of what we really know about sleep deprivation and poor sleep.

Treating insomnia is a different matter. People with insomnia will definitel consent to interventions, including long-term interventions. Whether or not any evidence exists for various interventions other than pharmaceutical sleep aids, I'm not all that aware of. Out of all the over the counter supplements people recommend, I'm pretty sure melatonin is the only one known to work, but it has drawbacks in that it tends to leave you drowsy when you wake and some people report wild and disturbing dreams. I'm sure it's worth trying, though.

There is plenty of pop sleep hygiene advice out there. I have no idea what sort of evidence other than anecdote it really has behind it, either, but it's also harmless to try. The standard keep your room cool, remove all lights, commit to a regular schedule, be in bed 30 minutes before you plan to sleep, all that that I'm sure you've heard before. I know my wife is trying a bunch. I'm not sure how well it's working. I used to be an insomniac when I was a kid. Now I'm not. I didn't really do anything. That seems to be common as well, or at least a lot of podcast hosts reported the same thing. They were insomniacs. Now they're not.

Granted, I run 60 miles a week, lift four days a week, and rock climb three days a week. I'm sure a lot of people will just say that much exercise is going to make you tired. I do believe evidence suggests that, but I was just as active as a kid.

[bwb]

Try: https://shepherd.com/book/why-we-sleep (even though it is general it is still great imp).

Or, this book by this scientist on sleep: https://shepherd.com/best-books/the-science-of-dreams

It is heavily about dreams but touches on so much more.

[helph67]

Not books but hints. I use and recommend magnesium just before bed. "Magnesium: The Most Powerful Relaxation Mineral Available" https://www.huffpost.com/entry/magnesium-the-most-powerf_b_4...

From 2017 "Israeli firm 2breathe has developed a smart sensor and complementary app to help those who have difficulty nodding off" https://geeknewscentral.com/?s=2breathe